Topoisomerase I is a ubiquitous DNA-cleaving enzyme and an important therapeutic target in cancer chemotherapy for camptothecins (CPTs). These drugs stimulate DNA cleavage by topoisomerase I but exhibit little sequence preference, inducing toxicity and side effects. A convenient strategy to confer sequence specificity consists of the linkage of topoisomerase poisons to DNA sequence recognition elements. In this context, triple-helix-forming oligonucleotides (TFOs) covalently linked to CPTs were investigated for the capacity to direct topoisomerase I-mediated DNA cleavage in cells. In the first part of our study, we showed that these optimized conjugates were able to regulate gene expression in cells upon the use of a Photinus pyralis luciferase reporter gene system. Furthermore, the formation of covalent topoisomerase I/DNA complexes by the TFO-CPT conjugates was detected in cell nuclei. In the second part, we elucidated the molecular specificity of topoisomerase I cleavage by the conjugates by using modified DNA targets and in vitro cleavage assays. Mutations either in the triplex site or in the DNA duplex receptor are not tolerated; such DNA modifications completely abolished conjugate-induced cleavage all along the DNA. These results indicate that these conjugates may be further developed to improve chemotherapeutic cancer treatments by targeting topoisomerase I-induced DNA cleavage to appropriately chosen genes.Topoisomerase I (Topo I) is a ubiquitous nuclear enzyme involved in the control of DNA topology. During the catalytic cycle, the enzyme transiently cleaves DNA and forms a covalent 3Ј-phosphorotyrosyl adduct usually referred to as the cleavage complex (14,28,29). A number of drugs, such as the antitumor alkaloid camptothecin (CPT) (for reviews, see references 17 and 24) and indolocarbazole analogs of the antibiotic rebeccamycin family (9,23,30), act by blocking the religation step after DNA cleavage, thereby enhancing the formation of cleavage complexes (DNA/Topo I/drug ternary complexes), which constitute persistent DNA breaks believed to be responsible for cell death (20)(21)(22)28). Topo I poisons stimulate DNA cleavage at many sites along the double helix with a limited sequence preference (one or two bases around the cleavage site). However, the sequence specificity of the Topo I poison can be considerably enhanced by linkage to a DNA recognition element. Initially, Matteucci et al. (19) showed in vitro that the covalent attachment of CPT to a triple-helix-forming oligonucleotide (TFO) induces site-specific DNA cleavage near the end of the triple helix. In the same context, we showed that CPT and rebeccamycin derivatives covalently linked to a TFO induce Topo I to mediate a sequence-specific DNA cleavage near the triplex site (3, 6, 7) according to a preferred geometry (2). The use of triple-helical DNA structures offers an efficient strategy to target Topo I to specific DNA sequences. Consequently, TFO-drug conjugates may be potentially exploited to improve the efficacy and selectivity of chemo...